• The Journal of Korean Academy of Prosthodontics
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• v.46 no.2
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• pp.137-147
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• 2008

Statement of problem: Dental implant procedure has been recognized as a very effective treatment to rehabilitate fully or partially edentulous patients. However, mechanical failures such as screw loosening, screw fracture have been still reported frequently. Purpose: The purpose of this study was to evaluate the influence of tungsten carbide/carbon coating, which has superior hardness and frictional wear resistance, on implant-abutment screw loosening of three different joint connections after one million cyclic loading. Material and methods: The values of detorque before and after loading were measured in three different joint connections (Osstem Implant, Korea), one external butt joint, US II implant system and two internal cones, SS II and GS II system. The values of detorque before loading was analyzed by one-way ANOVA, and two-way ANOVA and Scheffe' test were performed for the value of detorque after loading. Results: 1. The values of initial detorque of tungsten carbide/carbon coated Ti alloy screw were smaller those of Ti alloy screw (P<.01), and there were no differences among implant systems in each screw (P>.05). 2. In comparison of loss rate of detorque value after cyclic loading, US II system was greater than SS II and GS II system but there was no difference between SS II and GS II system (P<.01). 3. Loss rates of detorque value after cyclic loading decreased consistently at tungsten carbide/carbon coated Ti alloy screw comparing with Ti alloy screw in all implant systems (P<.01), and there were no differences among three systems in reduction of loss rates by using tungsten carbide/carbon coated Ti alloy screw (P>.05). Conclusion: Tungsten carbide/carbon coating to increase preload with reduction of friction resistance was a effective way to decrease screw loosening by functional loading.

• The Journal of Advanced Prosthodontics
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• v.11 no.2
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• pp.105-111
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• 2019

PURPOSE. Limited data is available regarding the differences for possible microleakage problems and fitting accuracy of zirconia versus titanium abutments with various connection designs. The purpose of this in vitro study was to investigate the effect of connection design and abutment material on the sealing capability and fitting accuracy of abutments. MATERIALS AND METHODS. A total of 42 abutments with different connection designs [internal conical (IC), internal tri-channel (IT), and external hexagonal (EH)] and abutment materials [titanium (Ti) and zirconia (Zr)] were evaluated. The inner parts of implants were inoculated with $0.7{\mu}L$ of polymicrobial culture (P. gingivalis, T. forsythia, T. denticola and F. nucleatum) and connected with their respective abutments under sterile conditions. The penetration of bacteria into the surrounding media was assessed by the visual evaluation of turbidity at each time point and the number of colony forming units (CFUs) was counted. The marginal gap at the implant- abutment interface (IAI) was measured by scanning electron microscope. The data sets were statistically analyzed using Kruskal-Wallis followed by Mann-Whitney U tests with the Bonferroni-Holm correction (${\alpha}=.05$). RESULTS. Statistically significant difference was found among the groups based on the results of leaked colonies (P<.05). The EH-Ti group characterized by an external hexagonal connection were less resistant to bacterial leakage than the groups EH-Zr, IT-Zr, IT-Ti, IC-Zr, and IC-Ti (P<.05). The marginal misfit (in ${\mu}m$) of the groups were in the range of 2.7-4.0 (IC-Zr), 1.8-5.3 (IC-Ti), 6.5-17.1 (IT-Zr), 5.4-12.0 (IT-Ti), 16.8-22.7 (EH-Zr), and 10.3-15.4 (EH-Ti). CONCLUSION. The sealing capability and marginal fit of abutments were affected by the type of abutment material and connection design.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.6
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• pp.561-568
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• 2008

STATEMENT OF PROBLEM: Currently, many implant systems are developed and divided into two types according to their joint connection: external or internal connection. Regardless of the connection type, screw loosening is the biggest problem in implant-supported restoration. PURPOSE: The purpose of this study is to assess the difference in stability of abutment screws between the external and internal hexagonal connection types under cyclic loading. MATERIAL AND METHODS: Each of the 15 samples of external implants and internal abutments were tightened to 30 N/cm with a digital torque gauge, and cemented with a hemispherical metal cap. Each unit was then mounted in a $30^{\circ}$ inclined jig. Then each group was divided into 2 sub-groups based on different periods of cyclic loading with the loading machine (30 N/ cm - 300 N/cm,14 Hz: first group $1{\times}10^6$, $5{\times}10^6$ cyclic loading; second group $3{\times}10^6$, $3{\times}10^6$ for a total cyclic loading of $6{\times}10^6$) The removal torque value of the screw before and after cyclic loading was checked. SPSS statistical software for Windows was used for statistical analysis. Group means were calculated and compared by ANOVA, independent t-test, and paired t-test with ${\alpha}$=0.05. RESULTS: In the external hexagonal connection, the difference between the removal torque value of the abutment screw before loading, the value after $1{\tims}10^6$ cyclic loading, and the value after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading was not significant. The difference between the removal torque value after $3{\times}10^6$ cyclic loading and after $3{\times}10^6$, and additional $3{\times}10^6$ cyclic loading was not significant. In the internal hexagonal connection, the difference between the removal torque value before loading and the value after $1{\times}10^6$ cyclic loading was not significant, but the value after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading was reduced and the difference was significant (P < .05). In addition, in the internal hexagonal connection, the difference between the removal torque value after $3{\times}10^6$ cyclic loading and the value after $3{\times}10^6$, and additional $3{\times}10^6$ cyclic loading was not significant. CONCLUSION: The external hexagonal connection was more stable than the internal hexagonal connection after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading (t = 10.834, P < .001). There was no significant difference between the two systems after $3{\times}10^6$, and additional $3{\times}10^6$ cycles.

• The Journal of Korean Academy of Prosthodontics
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• v.41 no.4
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• pp.503-518
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• 2003

Statement of problem : There have been previous studies about considerable variations in machining accuracy and consistency in the implant-abutment-screw interfaces. Purpose : The purpose of this study was to evaluate the machining accuracy and consistency of implant/abutment/screw combinations on two randomly selected implants from each of four manufactures. Material and methods : In this study, screws were respectively used to secure a cemented abutment, to a hexlock implant fixture ; teflon coated titanium alloy screw(Torq-Tite) and titanium alloy screw in Steri--Oss system, gold-plated gold-palladium alloy screw(Gold-Tite) and titanium alloy screw in 3i system gild screw ana titanium screw in AVANA Dental Implant system, and titanium screws in Paragon System. The implants were perpendicularly mounted in polymethyl methacrylate autopolymerizing acrylic resin block(Orthodontic resin, Densply International Inc. USA) by use of dental surveyer. Each abutment screw was secured to the implant with recommended torque value using a digital torque controller. Each screw was again tightened after 10 minutes. All samples were cross sectioned with grinder-polisher unit(Omnilap 2000 SBT Inc) after embeded in liquid unsaturated polyester (Epovia, Cray Valley Inc) Results : There were the largest gaps in the neck areas of screws in hexagonal extension implants which were examined in this study. The leading edge of the abutment screw thread (superior surface) was in contact with the implant body thread, and the majority of the contacting surfaces were localized to the middle portion of the mating threads. Considerable variation in the contacting surfaces was noted in the samples evaluated. Amounts of contact in the abutment screw thread were larger for assemblies with Gold-Tite screw, gold alloy screw. Torq-Tite screw than those with titanium screws. The findings of intimate contact between the screw and screw seat were seen in all samples, regardless of manufacturers. However, microgap between the head and lateral neck surface of the screw and the abutment could be dectected in all samples. The findings of intimate contact between the platform of the implant and the bottom of the abutment were consistent in all samples, regardless of manufacturers. However, microgaps between the lateral surface of external hex of the fixture and the abutment could be dectected in all samples. Conclusion : Considerable variations in machining accuracy and consistency were noted in the samples and the implant-abutment-screw interfaces were incomplete. From the results of this study, further development of the system will be required, including improvements in pattern design.

• Journal of Periodontal and Implant Science
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• v.54 no.1
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• pp.53-62
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• 2024

Purpose: This study aimed to evaluate the long-term cumulative survival rate (CSR) of dental implants with micro-threads in the neck over a 10-year follow-up period and to examine the factors influencing the survival rate of dental implants. Methods: This retrospective study was based on radiographic and dental records. In total, 151 patients received 490 Oneplant^® dental implants with an implant neck micro-thread design during 2006-2010 in the Department of Periodontology of Seoul National University Dental Hospital. Implant survival was evaluated using Kaplan-Meier analysis. Cox proportional hazard regression analysis was used to identify the factors influencing implant failure. Results: Ten out of 490 implants (2.04%) failed due to fixture fracture. The CSR of the implants was 97.9%, and no significant difference was observed in the CSR between external-and internal-implant types (98.2% and 97.6%, respectively, P=0.670). In Cox regression analysis, 2-stage surgery significantly increased the risk of implant failure (hazard ratio: 4.769, P=0.039). There were no significant differences in influencing factors, including sex, age, implant diameter, length, fixture type, location, surgical procedure, bone grafting, and restoration type. Conclusions: Within the limitations of this retrospective study, the micro-thread design of the implant neck was found to be favorable for implant survival, with stable clinical outcomes.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.6
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• pp.664-670
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• 2004

Statement of problem. One of the common problems of dental implant prosthesis is the loosening of the screw that connects each component, and this problem is more common in single implant-supported prostheses with external connection. Purpose. The purpose of this study was to examine the changes of detorque values of abutment screws with external connection in different abutment heights. Materials and methods. After cyclic loading on three different abutment heights, detorque values were measured. Abutments were retained with titanium abutment screws tightened to 30 Ncm (30.5 kgmm) with digital torque gauge as recommended by the manufacturer. Replacing abutments, implants and titanium abutment screws with new ones at every measurement, initial detorque values were measured six times. In measuring de torque values after cyclic loading, Avana Cemented Abutments of 4.0 mm collar, 7.0 mm height (Osstem Co., Ltd., Seoul, Korea) were used with three different lengths of 5.0, 8.0, 11.0 mm. Shorter abutments were made by milling of 11.0 mm abutment to have the same force-exercised area of 4.5 mm diameter. Sine curve force (20N-320N, 14Hz) was applied, and detorque values were measured after cyclic loading of 2 million times by loading machine. Detorque values of initial and after-loading were measured by digital torque gauge. One-way ANOVA was employed to see if there was any influence from different abutment heights. Results. The results were as follows: 1. The initial detorque value was 27.8$\pm$0.93 kgmm, and the ratio of the initial detorque value to the tightening torque was 0.91(27.8/30.5). 2. Measured detorque values after cyclic loading were declined as the height of the abutment increased, that was, 5.0 mm; 22.3$\pm$0.82 kgmm, 8.0 mm; 21.8$\pm$0.93 kgmm, and 11.0 mm; 21.3$\pm$0.94 kgmm. 3. One-way ANOVA showed no statistically significant differences among these (p>0.05). 4. Noticeable mobility at the implant-abutment interface was not observed in any case after cyclic loading at all.

• Journal of the Korean Society of Radiology
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• v.14 no.3
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• pp.253-259
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• 2020

Mammography has the advantage of being economical, simple and effective in detecting microcalcification, but breast is a highly sensitive organ and is accompanied by the risk of an over-exposure. While accurate dose assessments are important to prevent this, current breast dose assessments are limited to breast implant patients. This purpose of this study was to identify dose variations due to tube voltages by forming a mock-up with breast implants for an accurate dosimetric assessment on breast implant patients. As a result, doses from the presence of breast implants were smaller than those from the absence of the mammal. As the result of the change of the voltage to 26, 28, 30, and 32 kV, the imcreased tube voltage included larger dose regardless of the presence of Breast implant. Therefore, it is believed that diagnosis recommendations for breast implants will be possible if further studies on internal and external bioretical imaging and quality assessment are carried out as the basis for this study.

• The Journal of Advanced Prosthodontics
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• v.6 no.1
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• pp.46-52
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• 2014

PURPOSE. The aim of this study was to evaluate the interface accuracy of computer-assisted designed and manufactured (CAD/CAM) titanium abutments and implant fixture compared to gold-cast UCLA abutments. MATERIALS AND METHODS. An external connection implant system (Mark III, n=10) and an internal connection implant system (Replace Select, n=10) were used, 5 of each group were connected to milled titanium abutment and the rest were connected to the gold-cast UCLA abutments. The implant fixture and abutment were tightened to torque of 35 Ncm using a digital torque gauge, and initial detorque values were measured 10 minutes after tightening. To mimic the mastication, a cyclic loading was applied at 14 Hz for one million cycles, with the stress amplitude range being within 0 N to 100 N. After the cyclic loading, detorque values were measured again. The fixture-abutment gaps were measured under a microscope and recorded with an accuracy of ${\pm}0.1{\mu}m$ at 50 points. RESULTS. Initial detorque values of milled abutment were significantly higher than those of cast abutment (P<.05). Detorque values after one million dynamic cyclic loadings were not significantly different (P>.05). After cyclic loading, detorque values of cast abutment increased, but those of milled abutment decreased (P<.05). There was no significant difference of gap dimension between the milled abutment group and the cast abutment group after cyclic loading. CONCLUSION. In conclusion, CAD/CAM milled titanium abutment can be fabricated with sufficient accuracy to permit screw joint stability between abutment and fixture comparable to that of the traditional gold cast UCLA abutment.

• The Journal of the Korea Contents Association
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• v.14 no.9
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• pp.343-349
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• 2014

The dental osseointegration implant should be enough to endure occlusion load and it's required to have efficient design and use of implant to disperse the stress into bones properly. Solidworks as a finite element analysis program for modeling and analysis of stress distribution was used for the research. The simple crown model was designed on applying conjoined condition with tightening torque of 20 Ncm of a abutment screw between a cement retained implant abutment and a fixture. A $45^{\circ}$ oblique loading from lingual to buccal side on buccal cusps of crown and performed finite element analysis by 100 N of external load. The results by a analysis for stress distribution of supporting bones of fixture were as below. The von Mises stress was concentrated on the upper side of supporting compact bone regardless of the diameters and lengths of fixture, and the efficiency result of stress reduction was increase of fixture's diameter than it's length. Therefore, it's effective to use wider fixture as possible to the conditions of supporting jaw bone.

• Journal of Technologic Dentistry
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• v.43 no.3
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• pp.99-105
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• 2021

Purpose: This study aims to examine the stress distribution effect of tightening torques of different abutment screws in a custom-abutment implant system on the abutment-fixture connection interface stability using finite element analysis. Methods: The custom-abutment implant system structures used in this study were designed using CATIA program. It was presumed that the abutment screws with a tightening torque of 10, 20, and 30 N·cm fixed the abutment and fixture. Furthermore, two external loadings, vertical loading and oblique loading, were applied. Results: When the screw tightening torque was 10 N·cm, the maximum stress value of the abutment screw was 287.2 MPa that is equivalent to 33% of Ti-6Al-4V yield strength. When the tightening torque was 20 N·cm, the maximum stress value of the abutment screw was 573.9 MPa that is equivalent to 65% of Ti-6Al-4V yield strength. When the tightening torque was 30 N·cm, the maximum stress value of the abutment screw was 859.6 MPa that is similar to the Ti-6Al-4V yield strength. Conclusion: As the screw preload rose when applying each tightening torque to the custom-abutment implant system, the equivalent stress increased. It was found that the tightening torque of the abutment influenced the abutment-fixture connection interface stability. The analysis results indicate that a custom-abutment implant system should closely consider the optimal tightening torque according to clinical functional loads.